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Honored Contributor
Posts: 32,661
Registered: ‎08-23-2010

Re: Getting switched with little warning into Medicare Advantage

[ Edited ]

@pitdakota wrote:

@Tinkrbl44 wrote:

@pitdakota wrote:

@Tinkrbl44, I am trying to explain that Part B is not a medicare supplement or medi-gap plan.  That is all.  Just want to make sure that people understand what part A and part B covers. 

 

But I also don't want people getting confused thinking part B is a medi-gap plan and think that they don't need part B.   They are not the same thing.   

 

medi-gap plans are not offered by medicare at all, they are offered by private insurance companies and help to cover costs that are not covered by parts A and B for those enrolled in traditional medicare.     That's all.  Heart

 

 


@pitdakota

 

I went back and re-read all my comments and there is nothing to even suggest that people don't need Part B. The only suggestions of that came from your posts.  

 

If anyone is not clear, they can google "what is medicare supplement?" and see all the "initial" plan options for Part B. 

 

@pitdakota   I'm not presuming to hold a Medicare insurance class here, so if you wish to continue to go into details, by all means do.   That was never my intent here.


_______________________________________________________

 

@Tinkrbl44, I think we are basically on the same page, except your use of the wording along with part B medicare is not accurate and that is what could possibly be confusing to people that are trying to figure out what they need to do for Medicare.

 

You posted before in the thread:

 

"you will need to select a Medicare Supplement (Part B)" and 

 

"Depending on which informational website you review, the part B is often referred to as a supplement or Medi-gap policy"

 

If anyone is reading a website that refers to Medicare part B as Medi-gap insurance, they need to move on to another website because that information is not accurate and the author (s) are very confused.

 

Someone knowledgeable in the health insurance industry would not refer Part B as "Medi-gap" insurance and if they do, their understanding of Medicare is questionable.  That is why it is important to understand that Medicare part B is not supplemental coverage.  I don't mean that you are not knowledgeable.  That is not my point at all.  But if a website calls Part B a Medi-gap plan, that is a red flag to not rely on the information posted on that website.

 

For traditional medicare, in order to receive full coverage the individual should enroll in Part A and Part B. 

 

This traditional medicare coverage will not cover all expenses so there are medicare supplemental insurance plans offered by private insurance plans that will help cover what parts A and B don't cover.  That is what medi-gap or supplemental  insurance is.  

 

Someone might get confused if they call and start asking about Medi-gap insurance when they are really talking about Medicare Part B.  So it is important for people to understand the difference if they are evaluating enrolling in traditional medicare.  

 

 

@pitdakota

 

I really don't know why you keep dwelling on a point that no one here has disputed (needing both parts A & B for traditional Medicare) ....  or why you keep focusing on "someone might get confused".     It appears to be muddying the waters.  

 

I also don't know what you mean "someone might get confused if they call" ... call who?   Who are you talking about?

 

Rather than offer any more simple explanations to a complex subject, I am adding a link from Medicare.gov -- "What's Medicare Supplement Insurance (Medigap)?"  

 

And I will trust that you believe Medicare.gov to be a reliable informational website.     If you don't, then I can't imagine what you consider to be "reliable".

 

We could continue to discuss this, but I think it's in the best interest of anyone reading this that we don't split hairs.   I would hate to think anyone would ever make important Medicare coverage decisions based on something they read on a shopping network message board.     

Respected Contributor
Posts: 3,913
Registered: ‎03-19-2010

Re: Getting switched with little warning into Medicare Advantage

[ Edited ]

@Witchy Woman

I am glad you posted.  I am a retired Federal employee also and am reaching Medicare eligibility age soon.  I am CSRS also.

 

I plan on signing up for Part B and also keeping my FEHB plan, which is currently a plan under Aetna.  As long as they don't increase their rates for this plan, it is comparable to a supplemental plan.

 

My DH is a former federal retiree also, but under FERS, so his Medicare Part B is withdrawn from his social security.  He also used GEHA for a couple of years post retirement, but last year switched over to Aetna

 

I will want my Medicare payment withdrawn from my annuity, so I have to research that.

 

--------

I saw your post to Isobel, so I hope she will reply.

 

Esteemed Contributor
Posts: 6,847
Registered: ‎03-09-2010

Re: Getting switched with little warning into Medicare Advantage

[ Edited ]

From:  https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html

 

What's Medicare Supplement Insurance (Medigap)?
 

A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

 

Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

 

A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

 

8 things to know about Medigap policies 

 

  1. You must have Medicare Part A and Part B.
  2. If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
  3. You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
  4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
  5. You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
  6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
  7. Some Medigap policies sold in the past cover prescription drugs, but Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
  8. It's illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan

 

THERE IS MORE INFORMATION CONTAINED IN THE LINKED ARTICLE.

The more I learn the more I realize how little I know.
Are you setting an example or being an example?
Valued Contributor
Posts: 559
Registered: ‎03-09-2010

Re: Getting switched with little warning into Medicare Advantage

After reading all the posts sure seems like there's a lot of unnecessary confusion about Medicare. I started doing research about 6 months ahead of time and also went to classes that are offered.

As far as MA not covering everything my employer based insurance didn't either. Be proactive and informed.
Respected Contributor
Posts: 3,466
Registered: ‎04-04-2015

Re: Getting switched with little warning into Medicare Advantage

OPM  will withhold the medicare premium from your retirement, but they must receive the request to do so from CMS:

 

My Annuity and Benefits Medicare

Medicare Premiums

If you are not receiving social security benefits, you can have Medicare premiums withheld from your annuity payments.   We must receive a request for the withholding from the Centers for Medicare and Medicaid Services. We cannot withhold premiums based on your direct request or even one from the Social Security Administration.  However, the Social Security district office may be able to give you additional information.

 

I used this email address to ask CMS to help me  and the woman who worked with me was extremely helpful:

 

OPMMAILBOX@cms.hhs.gov

 

She asked me for my CSA# and she basically took it from there.

 

Hope this helps.

Honored Contributor
Posts: 18,504
Registered: ‎05-23-2010

Re: Getting switched with little warning into Medicare Advantage


@ballyk wrote:
After reading all the posts sure seems like there's a lot of unnecessary confusion about Medicare. I started doing research about 6 months ahead of time and also went to classes that are offered.

As far as MA not covering everything my employer based insurance didn't either. Be proactive and informed.

 

 

Every Medicare thread that I've seen on these forums goes this way - every single one. There is good info, bad info, confusing info, partly good info and "it depends" info. There are semantics issues - people mean essentially the same thing but express it differently and people take issue and things get messy, muddy, and useless after a certain point.

 

Everyone who contributes *means* well, I totally believe that, but honestly - all facets of obtaining Medicare coverage that are relevant to every situation just can't be presented. I would hope that those who need information get it from a professional, not from these forums.  

 

What if you think what you need to know is responded to incorrectly or only partially, and you take that person's info as true. Oops. What if the information is correct but you misinterpret it? Oops.  And on and on. 

 

Get the help of those whose are certified and whose  business it is to know ALL about EVERY DETAIL of Medicare in YOUR STATE, in every situation. No one else knows like those people know.

Life without Mexican food is no life at all
Esteemed Contributor
Posts: 7,013
Registered: ‎03-15-2010

Re: Getting switched with little warning into Medicare Advantage

@Isobel Archer

 

Thanks so much!

 

I worked at OPM for 26 years and didn't know this -- and I'd like to think I knew a lot about Federal benefits -- but not Medicare.

 

I'm grateful for your response and appreciate the detailed directions.

 

My 38 years working for the Federal government were good ones.  I spent time at the White House, with Congress and then in a Federal agency.  Never thought much about my benefits until I was eligible to retire -- and then, worked 5 more years.  Staying in CSRS was the best thing I ever did!

 

Thanks again.

Esteemed Contributor
Posts: 7,013
Registered: ‎03-15-2010

Re: Getting switched with little warning into Medicare Advantage

@Allegheny

 

@Isobel Archer was kind enough to provide details.  This was something I had no clue about and, now that I know, will pursue.  Would rather just not thinking about mailing that check sometimes!

 

CSRS was the best plan, wasn't it?  I was there when FERS was introduced and in the public affairs office that helped sell it to employees.  I had to try to convince others, but never switched myself because it would have meant I had to work past 55.  As it turned out, I worked until I was 60, so....And I participated in the Thrift plan from day one.  Now, I am thankful I did and grateful for the benefits that were provided.

 

GEHA is a good plan, but they have cut way back on what they pay for drugs.  I might try to research another plan at open season, but costs keep going up on most of them.  GEHA has held pretty steady over the years.

 

Hope you are enjoying your retirement as much as I do.  I left in 2010 and haven't missed anything about working.  Particularly, the 2 hour commute every day to Washington, DC!

Trusted Contributor
Posts: 1,560
Registered: ‎12-31-2013

Re: Getting switched with little warning into Medicare Advantage

It seems unlikely that the OP would have only received one notification before being switched.  I personally received several letters from my insurance company over a period of several months before I was eligible for medicare regarding the potential upcoming switch.  I chose to go with a different company and simply called mine to make sure my existing policy was cancelled in a timely fashion.  

 

This is another lesson that we are all responsible for understanding what is happening with our own health care and financial business especially when it is time to get medicare.   

Respected Contributor
Posts: 2,536
Registered: ‎03-11-2010

Re: Getting switched with little warning into Medicare Advantage


@scotnovel wrote:

It seems unlikely that the OP would have only received one notification before being switched.  I personally received several letters from my insurance company over a period of several months before I was eligible for medicare regarding the potential upcoming switch.  I chose to go with a different company and simply called mine to make sure my existing policy was cancelled in a timely fashion.  

 

This is another lesson that we are all responsible for understanding what is happening with our own health care and financial business especially when it is time to get medicare.   


 

 

I don't disagree but sometimes we don't even know that we don't know something.  She didn't know that signing up with a different plan wasn't enough.  She probably thought the rest of the mail was more solicitations.  She made a mistake.  But sometimes we just don't know we're doing something the wrong way.  I know I'd have thought if I signed up for a certain insurance, that that's the insurance I'd have.  I wouldn't have thought the previous insurance had rights to continue considering me their client after I switched.

 

I think there's a reason the previous insurance did what they did...because they CAN.  Not because they should.  There's $$$ involved - that's why they're doing this.   They have the right to send letters and if there's no response, they can continue to believe you're their customer.  It should be the other way around.  

 

What if this was the case with every business you patronize???